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MHA 707 Exam C – Questions With Detailed Answers
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MHA 707 Exam C – Questions With Detailed Answers
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By: shrukh1 • 1 month ago
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MHA 707 Exam C – Questions With Detailed AnswersWhat is "asymmetry of information"? Why is it important in HC ? - ✔ •Physician vs. patient (vs. 3rd Party payer)
What is "non-marketability of risk"? - ✔ inherent if medicine and medical
practice
Health is not a marketable product, that is, it cannot be exchanged between
consumers
Moral Hazard - ✔ behaving differently when you know someone else
is taking the risk (Induced demand)
Adverse Selection - ✔ the sicker people likely want more insurance (the
healthier, less)
pooling of risk - ✔ sharing risk proportionately among many is a basic insurance
concept
National Health Expenditure Accounts (NHEA) - ✔ •Provide official estimates of health care spending in the United States and Measures health care consumption and health care investment
National Health Expenditure Accounts (NHEA) produce: - ✔ National Health Expenditures (NHE), Health Consumption Expenditures (HCE), Personal Health Care (PHC)
How much $ is spent on HC in US: absolute, per capita and as a % of GDP? - ✔ •$3.49 trillion
•17.9% of GDP
•$10,739 per capita
Percentage of $ spent in hospitals? On doctors? On Rx drugs? - ✔ •About 33% - hospitals
•About 20% - physicians
•About 9.5% (10.5% in 2019) - drugs Chronic disease - what is it & why is it important? What percent of NHE is spent on chronic disease? - ✔ conditions that last 1 year or more and require ongoing medical attention or limit activities of daily living or both.
- 90% of the NHE are for chronic and mental health diseases.
What are "personal behaviors" and how do they fit into the leading causes of death? - ✔ Tobacco, obesity, poor diet, substance misuse/abuse
-Half of the mortality from 10 leading CODs attributed to personal behaviors
What percent of Americans are hospitalized each year? - ✔ only 6.7% of Americans were hospitalized in 2018
What portion of Americans are uninsured? What portion of Americans under age 65 are covered by private health insurance? - ✔ 8% of people under the age of 65 were uninsured in 2019
** leaves 26.4 M uninsured **
About 66% of people under the age of 65 are covered through private insurance
Cost Plus Reimbursement - ✔ a payment scheme in which reimbursement to a provider is based on cost plus a factor to cover the value of capital
fee-for-service - ✔ a system under which doctors and hospitals receive a payment for each service they provide
•Provider-centric outcome
Capitation - ✔ •Fixed prepayment per person to the health care provider for an agreed-on array of services during a contract period (Per member/per month)
•May put the physician at odds with the patient
Value Based Payment - ✔ a payment system in which provider payments are linked to the cost and quality of care
MCO (managed care organization) - ✔ responsible for the health of a group of enrollees; can be a health plan, hospital, physician group, or health
system.
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